Author Interviews, Geriatrics, Mineral Metabolism / 22.10.2015

MedicalResearch.com Interview with: Andrew M Hinson, MD UAMS Postdoctoral Research Fellow Thyroid/Parathyroid Diseases & Surgery and Donald L. Bodenner, MD, PhD Department of Otolaryngology-Head and Neck Surgery Department of Geriatrics University of Arkansas for Medical Sciences, Little Rock, Arkansas. Medical Research: What is the background for this study? Response: Proton pump inhibitors (PPIs)​ are widely prescribed, highly effective and generally safe for the treatment of acid-related gastrointestinal disorders. However, there are risks that may be elevated for some older people when PPIs are used in high doses over long periods of time. There is also evidence that fracture risk may even be higher in older patients who are being treated with concurrent oral bisphosphonate medications, which are used to prevent fractures in patients with osteoporosis. While the mechanism remains unknown, PPIs may increase fracture risk by decreasing gastrointestinal absorption (e.g., calcium, vitamin B12, and/or bisphosphonates) or by inhibiting a major mechanism by which bisphosphonates work. To learn more about this process, we studied patients 60 years or older with normal renal function and vitamin D levels to see how PPIs (with and without concurrent bisphosphonate administration) impacted measurements in parathyroid hormone (PTH) and calcium. Medical Research: What are the main findings? Response: We found that chronic PPI exposure in elderly adults is associated with mild secondary hyperparathyroidism regardless of concurrent oral blood pressure administration. Secondary hyperparathyroidism refers to the excessive secretion of PTH by the parathyroid glands in response to low blood calcium levels. This is often associated with renal failure; however, all of our patients had normal renal function. (more…)